The pregnant teen, the villager giving birth far from home, the woman imprisoned for miscarrying: pregnancy in El Salvador, where women can’t choose where, or whether, to give birth
Midwives who work in the poor, rural stretches of El Salvador rarely travel alone. They often visit gang-controlled areas to tend to their patients, women who have little access to medical care and even less say over their reproductive lives.
As of 1997, it is illegal to have an abortion in El Salvador. Women who miscarry or have stillbirths can be charged with homicide, which comes with a sentence of up to 50 years. About a third of all pregnancies are of teenagers between the ages of 15 and 19, some of whom have been raped. A common concern among survivors is how they’ll support their child.
So women and girls have their babies, whether they want to or not, whether they’re ready to or not. An alarming number feel they have too few options and resort to taking their own lives. Suicide is now the primary cause of death among pregnant teens, with girls swallowing sulfur pills, traditionally used to wash beans.
It is in this climate that midwives spend their days hiking through cornfields, fending off dogs with sticks, carrying syringes loaded with contraception, advising girls on how to avoid pregnancy, and coaching others after they’ve conceived.